In recent months, federal agents have of a Southern California hospital, 鈥 sometimes shackled 鈥 in , and into a surgical center.
U.S. Immigration and Customs Enforcement agents have also shown up at community clinics. Health providers say that officers have tried to hosting a mobile clinic, waved a machine gun in the faces of clinicians serving the homeless, and hauled a passerby into an unmarked car outside a community health center.
In response to such immigration enforcement activity in and around clinics and hospitals, Democratic Gov. Gavin Newsom last month signed , which prohibits medical establishments from allowing federal agents without a valid search warrant or court order into private areas, including places where patients receive treatment or discuss health matters.
But while the bill received broad support from medical groups, health care workers, and immigrant rights advocates, legal experts say California can鈥檛 stop federal authorities from carrying out duties in public places, which include hospital lobbies and general waiting areas, health facility parking lots, and surrounding neighborhoods 鈥 places where recent ICE activities have sparked outrage and fear. Previous federal restrictions on immigration enforcement in or near sensitive areas, including health care establishments, were rescinded by the Trump administration in January.
鈥淭he issue that states encounter is the ,鈥 said , a supervising attorney and clinical teaching fellow at Georgetown Law. She said the federal government does have the right to conduct enforcement activities, and there are limits to what the state can do to stop them.
California鈥檚 law designates a patient鈥檚 immigration status and birthplace as protected information, which like medical records cannot be disclosed to law enforcement without a warrant or court order. And it requires health care facilities to have clear procedures for handling requests from immigration authorities, including training staff to immediately notify a designated administrator or legal counsel if agents ask to enter a private area or review patient records.
Several other Democratic-led states have also taken up legislation to protect patients at hospitals and health centers. In May, Colorado Gov. Jared Polis signed the bill, which penalizes hospitals for unauthorized sharing of information about people in the country illegally and bars ICE agents from entering private areas of health care facilities without a judicial warrant. In Maryland, requiring the attorney general to create guidance on keeping ICE out of health care facilities went into effect in June. New Mexico has instituted , and Rhode Island has from asking patients about their immigration status.
Republican-led states have aligned with federal efforts to prevent health care spending on immigrants without legal authorization. Such immigrants are not eligible for comprehensive Medicaid coverage, but states do bill the federal government for in certain cases. Under a , Florida requires hospitals that accept Medicaid to ask about a patient鈥檚 legal status. In Texas, hospitals now have to report how much they spend on care for immigrants without legal authorization.
鈥淭exans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,鈥 Gov. Greg Abbott said in issuing his last year.
California鈥檚 efforts to rein in federal enforcement come as the state, where more than a quarter of residents , has become a target of President Donald Trump鈥檚 immigration crackdown. Newsom signed SB 81 as part of a prohibiting immigration agents from entering schools without a warrant, requiring law enforcement officers to identify themselves, and banning officers from wearing masks. SB 81 was passed on a party-line vote with no formal opposition.
鈥淲e鈥檙e not North Korea,鈥 Newsom said during a September bill-signing ceremony. 鈥淲e鈥檙e pushing back against these authoritarian tendencies and actions of this administration.鈥
Some supporters of the bill and legal experts said California鈥檚 law can prevent ICE from violating existing patient privacy rights. Those include the Fourth Amendment, which without a warrant in places where people have a reasonable expectation of privacy. Valid warrants must be . But ICE agents frequently use administrative warrants to try to gain access to private areas they don鈥檛 have the authority to enter, Genovese said.
鈥淧eople don鈥檛 always understand the difference between an administrative warrant, which is a meaningless piece of paper, versus a judicial warrant that is enforceable,鈥 Genovese said. Judicial warrants are rarely issued in immigration cases, she added.
The Department of Homeland Security has said or identification requirements for law enforcement officers, slamming them as unconstitutional. The department did not respond to a request for comment on the state鈥檚 new rules for health care facilities, which went into immediate effect.
Tanya Broder, a senior counsel with the National Immigration Law Center, said immigration arrests at health care facilities appear to be relatively rare. But the federal decision to rescind protections around sensitive areas, she said, 鈥渉as generated fear and uncertainty across the country.鈥 Many of the most high-profile news reports of immigration agents at health care facilities have been in California, largely involving detained patients brought in for care.
The California Nurses Association, the state鈥檚 largest nurses union, was a co-sponsor of the bill and raised concerns about the treatment of Milagro Solis-Portillo, a 36-year-old Salvadoran woman who was under round-the-clock ICE surveillance at Glendale Memorial Hospital over the summer.
Union leaders also of agents at California Hospital Medical Center south of downtown Los Angeles. According to Anne Caputo-Pearl, a labor and delivery nurse and the chief union representative at the hospital, agents brought in a patient on Oct. 21 and remained in the patient鈥檚 room for almost a week. The reported that a TikTok streamer, Carlitos Ricardo Parias, was taken to the hospital that day after he was wounded during an immigration enforcement operation in South Los Angeles.
The presence of ICE was intimidating for nurses and patients, Caputo-Pearl said, and prompted visitor restrictions at the hospital. 鈥淲e want better clarification,鈥 she said. 鈥淲hy is it that these agents are allowed to be in the room?鈥
Hospital and clinic representatives, however, said they are already following the law鈥檚 requirements, which largely reinforce put out by state Attorney General Rob Bonta in December.
Community clinics throughout Los Angeles County, which serve over 2 million patients a year, including a large portion of immigrants, have been implementing the attorney general鈥檚 guidelines for months, said Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County. But she said the law should help ensure uniform standards across health facilities that clinics refer out to and reassure patients that procedures are in place to protect them.
Still, it can鈥檛 prevent immigration raids from happening in the broader community, which have made some patients and even health workers afraid to venture outside, McCarthy said. Some incidents have occurred near clinics, including an arrest of a passerby outside a clinic in East Los Angeles, which a security guard caught on video, she said.
鈥淲e鈥檝e had clinic staff say, 鈥業s it safe for me to go out?鈥欌 she said.
At St. John鈥檚 Community Health, a network of 24 community health centers and five mobile clinics in South Los Angeles and the Inland Empire, CEO Jim Mangia agreed that the new law can鈥檛 prevent all immigration enforcement activity, but he said it does give clinics a tool to push back if agents show up, something his staff has already had to do.
Mangia said St. John鈥檚 staff had two encounters with immigration agents over the summer. In one, he said, staff stopped armed officers from entering a gated parking lot at a drug and alcohol recovery center where doctors and nurses were seeing patients at a mobile health clinic.
Another occurred in July, when immigration agents MacArthur Park on horses and in armored vehicles, in a show of force by the Trump administration. Mangia said masked officers in full tactical gear surrounded a street medicine tent where St. John鈥檚 providers were tending to homeless patients, screamed at staff to get out, and pointed a gun at them. The providers were so shaken by the episode, Mangia said, that he had to bring in mental health professionals to help them feel safe going back out on the street.
A DHS spokesperson told CalMatters that in the rare instance where agents enter certain sensitive locations, officers would need 鈥.鈥
Since then, St. John鈥檚 has doubled down on providing support and training to staff and has offered patients afraid to go out the option of home medical visits and grocery deliveries. Patient fears and ICE activity have decreased since the summer, Mangia said, but with DHS planning to , he doubts that will last.
